Mammogram – Do You Know The Facts?

October is Breast Cancer Awareness Month. I didn’t realize that when I first wrote this post but it works in well with today’s topic. I recently received the letter telling me that my annual mammogram showed no signs of breast cancer. Very reassuring and, to me, well worth the few moments of discomfort caused by the mammogram.

Not everyone agrees. There are a number of women out there who won’t go for a mammogram without really knowing why. I believe that whether or not someone goes for a mammogram is a personal decision but it should be a decision based on fact, not rumors or innuendo.

Breast cancer is the most common cancer among Canadian women and also occurs in men.

In 2014, an estimated 24,400 Canadian women will be diagnosed with breast cancer. 5,000 will die from it;

About 210 men are expected to be diagnosed with breast cancer and 60 will die from it.

In 2013, an estimated 232,340 new cases of breast cancer were expected to be diagnosed in women in the USA. 39,620 were expected to die from it;

About 2,240 new cases of breast cancer were expected to be diagnosed in men in 2013.

Benefits of Screening Mammograms:

In 2011 and 2012, approximately 1,138,000 (60%) Ontario women, 50–74 years old, were screened for breast cancer with a mammogram;

In 2012, approximately 98% of Ontario women 50-74 years old, who had an abnormal mammogram, were fully diagnosed within 6 months.

According to the Ontario Breast Screening Program, “Breast cancer screening mammograms find cancers when they are small and less likely to have spread. Early detection means that most women have more treatment options, a reduced chance of cancer recurrence, and an improved chance of survival.” http://www.csqi.on.ca/type/breast/

The National Cancer Institute (USA) Fact Sheet, as at 03/25/2014 states: “Screening mammography can help reduce the number of deaths from breast cancer among women ages 40 to 74. It is recommended that women in this age group have a mammogram every two years. If there are risk factors, such as family history of breast cancer, this could change to a younger age or greater frequency.” http://www.cancer.gov/cancertopics/factsheet/detection/mammograms

Thanks to improvements in screening, detection and treatment, the 5 year survival rate for men is 80% and for women is 88%.

How screening mammograms are done:

A woman stands in front of the mammography machine and her breast is placed between the two plastic compression plates. Two views – from different angles – are taken of each breast. Compressing the breast does cause a certain amount of discomfort, but it only lasts a few seconds. The compression is necessary because it increases the clearness of the image and allows less radiation to be used.

What exactly is a mammogram?

A mammogram is a low-dose x-ray that produces an image of the inner breast;

Can be used to identify a small cancer in a curable stage;

Having a first mammogram at age 40 sets a base-line and allows further mammograms to identify minor changes to the breast over time. This helps to detect breast cancer at an early stage.

It is the most efficient screening method, at this time, to detect early breast cancer;

There are two types of mammograms:

Screening mammogram, used as a preventative tool to check for breast cancer in women who have no sign of the disease;

Diagnostic mammogram, checks for breast cancer after a lump or other sign or symptom of the disease has been found.

What can a screening mammogram show up?

Changes to the breast structure;

Lumps that are too small to be felt;

Abnormal areas of the breast;

Cysts;

Micro-calcification (small deposits of calcium that sometimes indicate the presence of breast cancer);

Tumors.

Risks associated with mammograms:

Mammograms are not foolproof and it is necessary to be armed with the facts. If not sure about any information received, insist on clarification. Following are some of the limitations of the screening mammogram:

False-positive results: the mammogram may show an abnormality, which must be followed up with additional testing – diagnostic mammograms, ultrasound and/or biopsy;

False positives are more common for younger women, women who have had previous breast biopsies, and women who are taking estrogen (hormone therapy);

Overdiagnosis and Overtreatment – this is where you ask all the questions and want to know all the reasons for treatment:

Screening mammograms can find cancers and cases of ductal carcinoma in situ (DCIS). DCIS are noninvasive tumors in which abnormal cells, that may become cancerous, build up in the lining of breast ducts and therefore need to be treated. Screening mammograms can also find cancers or DCIS that will never cause symptoms or threaten a woman’s life and therefore not needing treatment. Unfortunately, doctors often cannot distinguish between the two, and so to be safe, they are all treated. This exposes women unnecessarily to the adverse effects associated with cancer treatment.

Other limitations include:

False-negatives: Screening mammograms miss about 20% of breast cancers present at time of screening. The main cause is high-breast density, occurring more often among younger women who normally have greater breast density.

False-negatives can lead to delays in treatment and a false sense of security.

Radiation exposure:

Since mammograms require very small doses of radiation, the risk of harm from this radiation exposure is extremely small. However, repeated x-rays do have the potential to cause cancer. This is definitely something that should be discussed with your health care provider.

There is a lot of controversy going on at this time about the value of the screening mammogram. My personal opinion is this: This procedure can and does detect early tumors and/or changes in the breast which to me makes it an important tool. However, I strongly believe that we can’t just blindly accept any procedure or diagnosis. We need to do our homework and find out as much as we can about any potential problems and/or treatments. Never let the health care system intimidate you. Always stay in charge of your body and your health.

How do you feel about the screening mammogram?

Please don’t forget to share.

Talk to you again next week,

Lenie

Doctor at Computer – Image courtesy of imagerymajestic at FreeDigitalPhotos.net

Pink Ribbon – Image courtesy of scottchan at FreeDigitalPhotos.net

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34 Comments

Excellent and informed post Lenie! I lost my mother to breast cancer…10 years after she was diagnosed and treated and deemed cured. So I believe in screening and have a mammogram yearly…the diagnostic variety. Personally, I don’t mind them at all. Fact is, it is the best screening we have available today. But the continue to make great strides in this area, so maybe not too far in the future they’ll find something better. But I agree… ask questions and understand the procedure to ease your mind or fears.

LenieOctober 13, 2014

Jacquie – I’m sorry to hear about your mom. I had a sister who passed away at 37, leaving 4 young children who desperately needed her. That was tough. So yes, definitely you and I are great candidates for the annual mammogram and I always do feel a sense of relief when I get that letter. As far as making great strides, I just saw a report on how they hope to use MRI’s and robots in the future. the MRI will determine whether or not there is any indication of cancer, if so, the robot will do an ultrasound or biopsy while the patient is still in the MRI machine. Fascinating stuff.

CatarinaOctober 13, 2014

Had a mammogram once. They really scared me by saying something was wrong, which a large number of women are told even though that’s not the case. After doing it twice they concluded I was fine. Breast cancer is to a large extent genetic and it doens’t run in my family.

But the main reason I will never do it again is because all human beings develop cancer on and off in life. Our bodies normally overcome it. But if we are told we have cancer our mind will kill us. Rest assure that you have had cancer in your life, Lenie, it’s just that you are not aware of it.

A good example is the grandfather of a friend of mine had cancer but her mother convinced the doctor not to tell him. When he came back for a check up the cancer was gone.

Wish to point out though that women who have breast cancer in the family should definitely do mammograms on a regular basis.

LenieOctober 13, 2014

Hi Catarina – I agree that a wrong reading can be scary and that’s why I included the information about the false results. It’s important to question any results. I also agree that the word ‘cancer’ is enough to paralyze our thinking and a proper mindset is very important to the cure. And of course, the family history needs to be taken into account. To me, the most critical factor is knowledge. Know your body and the facts.

You’ve done a good job of collecting and presenting information about mammograms. You’ve provided links to information so readers can do their homework and make their own decisions Thanks.

LenieOctober 13, 2014

Hi Donna. What I really hoped to accomplish with this post is that anyone deciding to have the mammogram should not fear it. It truly isn’t a big deal. The other thing is that it’s not foolproof and people need to be aware of some of the problems. Knowledge is key.

Definitely something all woman should read. I’ve heard 40 is the magic age to get a mammogram. I wondering if they will lessen that. Better safe than sorry.

LenieOctober 13, 2014

Hi Krystle, I think the future may lower the age but I think the procedure could very well be different. There is always so much work going on in this area that I think screening by MRI may very well be the next step, but that’s just a guess. In the meantime, I think the mammogram is the best we have, even with it’s limitations.

Lenie, thanks for sharing these facts. You truly are increasing awareness. I had my first mamo last year and it was really not so bad. I had a few stressful days when they called me back for a second one, but then they were able to do look deeper and found that nothing was wrong. Along the whole process I kept wanting to back out, but now I’m so glad I went and I know I won’t have any problem going back regularly. There’s just no reason not to get one!

I’ve read a lot of the controversy surrounding the mammograms recently. While mammogram screening may not be perfect, it us the best option we have right now in my opinion. I do feel we need to combine it with other recommended screenings like self breast exams etc. And like you said Lenie, it’s important that we do our homework when it comes to or healthcare.

Very informative post Lenie and whether people decide to take your good advise or lean more away from science is up to them. Thanks for bringing up the discussion. I believe in yearly exams of physical health for both genders.

Hello Lenie
This is very informative post about breast cancer and need of mammogram.
Keeping aside little discomfort that it cases is worth bearing as it is only available process( if I am not wrong) to detect breast cancer.
every year the number of women developing this disease is increasing. But with advancement in technology is helping many to live a longer and healthier life.
this was very informative post ,all women must read and discuss their fear.
I am happy for you that you are safe and I wish u a happy and healthy life ahead.
Thanks for the great share.

I had my first mammogram at age 35, but only because I have really good health insurance and my regular doctor encouraged me to get one since it would be totally covered. It’s not a big deal and a great tech can make all the difference, plus it’s far less annoying than a pap smear 😉 It’s a tough call though how often they should be done as the medical community can’t seem to agree, or either doctors are afraid of doing screening less often since patients have been told forever to get such tests done often.

It seems women fear “finding out something” rather than having the actual mammogram test.I watch the technicians face like a hawk looking for any grimace or facial reaction. Sitting alone waiting for the tests results all kinds of scenarios play out,”What if I have cancer what will I tell my kids”? Even asking, “Will I go bald or wear a wig”? Having a mammogram you’re face to face with your own mortality. Plus having the air sucked your breast;flatter than a pancake…there’s that too.

LenieOctober 15, 2014

Actually, I don’t know about you but when I go for the mammogram it’s something that to me represents peace of mind, rather than all the awfulthings you mention. A mammogram may lead to early detection of cancer while it’s still in the curable stage. That to me outweighs all the rest.

Great article Lenie. What about thermography? It keeps showing up in all natural health magazines. There are claims that it is a better diagnostic tool.

LenieOctober 15, 2014

Frankly, I haven’t heard about thermography – something new for me to research – if it’s natural and effective than that’s a plus as far as I’m concerned, but not all things natural are better. I will be looking into it though – thanks for the info.

Nice job raising awareness during breast cancer awareness month. You did your homework! Very thorough. It’s not commonly mentioned that men can die of breast cancer too. But you were good enough to point that out. I’m obviously not a man and I know breast cancer is a difficult diagnosis for anyone, but I could imagine it being particularly difficult for a man to accept it and talk about it.

First This is great info really Good Article i like it You’ve done a good job of collecting and presenting information about mammograms. You’ve provided links to information so readers can do their homework and make their own decisions Thanks. i m first time visit your blog really impress , thank alot for sharing me keep it up
Regard
Leena

Very timely post Lenie. I’ve never had a mammogram, and I have heard that it is really uncomfortable. The thought of it does make me a little squeamish! But seeing that Jeri said a smear is worse makes me less freaked out. Smears are not exactly a party, but I always go for mine, they, like mammograms could literally save your life.

That was thorough, thank you Lenie!
I’ve had 2 mammograms and I couldn’t say they were even uncomfortable.
Unlike someone else stated up there, I sure would like to know if I had cancer. My mom died from one earlier this year. Her diagnose came so late that there was absolutely nothing they could do. Otherwise, she would have fought it like a tigress, that’s for sure. (It wasn’t breast cancer, but pancreatic, which has the worst possible prognosis in any case).

I remember when there was a great hue and cry about the dangers of radiation exposure during mammograms. That must have been about 10 or 15 years ago. What nonsense! I’m sure many more lives are saved than threatened. It only takes a few minutes out of your day, and yes, it’s like slamming a refrigerator door onto your boob, but it’s SO worth it. Thanks for posting, Lenie. We can never hear this message often enough!

Very important post! I had my first one last year when I turned 40 and was terrified. The nurse was so nice she saw I was scared and assured me the process was not bad. After I was surprised because it was not bad at all. So many women I know made the process seem horrifying so I had it in my mind it was going to be painful.

Don PurdumOctober 19, 2014

Hi Lenie,

There is no one in the world more precious to my than my amazing wife! I am so glad that there are people out there such as yourself sharing the importance of this issue and helping bring awareness to everyone.

Thanks so much,
Don Purdum

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